Problems are Solutions

product description

This book is not only a textbook on systemic psychotherapy and
consultation. It can also be used to gain ideas for the solution of
problems. At the same time, it conveys comprehensible insights into
the systemic rooting of human beings. Owing to its detailed subject
index, index of names and case and story index, it can also be used
as a reference book.

67 figures, 13 tables and over 80 case examples illustrate the subject
areas presented.

“This book is rich in content, competent and captivating, didactically
well-ordered and well thought-out, and can be recommended as a
textbook on systemic consultation and therapy.”
Prof. Dr. med. Dr. phil. Helm Stierlin

“The author successfully relates theory and practice very simply and
provides a solid grounding in the whole systemic way of thinking in a
communicative and friendly manner.”
Prof. Dr. F. Shulz von Thun

“In addition to other standard works, I recommend this book to stu-
dents and trainees who want a readable overview and to practicians
who need new ideas for their daily practice as an entertaining and not
too strenuous refresher course.”
Prof. Dr. Johannes Herwig-Lempp
(Kontext, German Family Therapy Journal)

“I have received your book and am very enthusiastic about its clarity,
readability, the wealth of information and 'truths' – a goldmine and a
pleasure. Thank you very much.”
Dr. Sybille Ebert-Wittich


Contents
Foreword by Helm Stierlin ................................................................17
1. Introduction and acknowledgments ...........................................19
2. What is systemic consultation? ....................................................25
2.1 Esteem .............................................................................................27
2.2 Problems are solutions ................................................................29
2.3 Problems and symptoms as relationship-forming powers
(cf. SCHMIDT 2005) .......................................................................31
2.4 Problems/symptoms/deficits as evidence of resources and
competence and as sources of information.............................35
2.5 Restrictions ....................................................................................41
2.6 The primacy of the narrated present ......................................42
2.7 The journey to a solution (cf. SCHMIDT 2004a).....................44
2.8 The precedence of practised behavior over recounted
emotional life ................................................................................46
2.9 Accepting clients' verbal statements ........................................48
2.10 Directive, client-orientated procedure and optimal
disappointment of expectations ..............................................50
2.11 The meaning of the context......................................................52
2.12 Constructivism, reality construction and using clients'
subjective theories .....................................................................55
2.13 The necessity of neutrality.................................................. 58
2.13.1 Neutrality of construct: Lack of respect on the part of the
therapeutic observer..................................................................58
2.13.2 Neutrality of change..................................................................59
2.13.3 Neutrality of relationships: Multidirectional partiality as a
therapeutic attitude....................................................................60
2.13.4 Neutrality of method.................................................................61
2.13.5 Neutrality towards oneself or the ability to question oneself
and one's own therapeutic offer ................................................62
2.14 The unintentional questioning approach .............................63
3. Fundamental systemic principles ...............................................65
3.1 Representational systems and their sub-modalities .............65
3.2 The basic systemic law of isomorphism and the
necessity of therapeutic deviance ............................................68
3.3 The consultant's subjective feelings .........................................72
3.3.1 Utilizing one's own experience as a consultant...........................72
3.3.2 The principle of isomorphism of feelings ...................................75
3.3.3 Respectful bonding as a balancing act, or the witch's position
as regards different realities ........................................................76
3.4 Crossing the border between problem and solution
or the position of the witch in reference to the problem and
the possibility of its solution.......................................................79
3.5 Tetralemma or the witch position in different
organizations of conflict.............................................................81
3.6 Utilizing the consultant's problems and quandaries............82
3.7 Three pragmatic principles for systemic interventions ......86
3.8 The secret of a bad conscience: Equilibrium, bonding
and order in systems ...................................................................87
3.8.1 Experiments and experiences of loyalty-bonding .......................88
3.8.1.1 ASCH 's experiment ..............................................................89
3.8.1.2 MILGRAM's Experiment .......................................................90
3.8.1.3 MANSSON's study on the justification of the
“final solution”.....................................................................94
3.8.1.4 ERICKSON's utilization of bonds of loyalty ..........................94
3.8.2 Attempt at a systemic explanation of obedience to authorities ...95
3.8.3 Conscience as a systemic organ of equilibrium ..........................96
3.8.4 Systemic balance ........................................................................98
3.8.5 Social systems and their conscience .........................................101
3.8.6 The archaic roots of conscience................................................103
3.9 Eco-systemic considerations: Order and hierarchy
between different systems .......................................................107
3.10 Principles of cooperation: Tit for Tat .................................111
3.11 Dealing with "resistance" or: There is another way .......113
3.11.1 “Resistance” against the consultant ........................................113
3.11.2 Resistance against the symptom .............................................116
3.12 Identity, self-confidence and belonging ..............................118
3.13 The impossibility of instructive communication...............120
3.14 On the impossibility of direct access to others'
experiences .................................................................................123
3.15 Living beings as autopoietic systems ...................................127
3.16 Systemic intervention as a perturbation expedient to
aim and solution in a system not yet sufficiently
disturbed ....................................................................................131
3.17 Exceptions to the rule become the rule ...............................135
3.18 Complexity and ability to act ................................................135
3.18.1 Reducing complexity: the principle of constructive
stultification (cf. NACHMANN 1996) .......................................136
3.18.2 Increasing complexity.............................................................139
3.19 On the necessity of saving face ..............................................140
3.20 Producing problems ................................................................142
3.21 Avoiding and utilizing negative language constructions 143
3.21.1 From negative to positive formulations of the goal ................144
3.21.2 The therapeutic use of negations (cf. MEISS & PRIOR 1994) ..145
3.21.2.1 “Packing up” suggestions and resources..........................145
3.21.2.2 Respecting the client's skepticism....................................146
3.22 Secrets .........................................................................................148
3.23 Rules stipulating what cannot not be done in the
psycho-social context ...............................................................151
3.24 The two main principles of responsibility according
to SIMON and WEBER ..............................................................154
3.25 Content and relationship aspects of communication.......154
3.26 Unable and unwilling: A pragmatic allegation .................155
3.27 The distinction between the context of therapy and
the context of social control ..................................................159
3.28 Dealing with emotions .............................................................159
3.29 Justice, innocence, happiness and freedom from
ambivalence: Four disillusions..............................................162
3.29.1 The illusion of justice .............................................................162
3.29.2 The illusion of innocence........................................................163
3.29.3 The illusion that happiness depends on chance.......................163
3.29.4 The illusion of freedom from ambivalence.............................164
3.30 The highest eco-systemic law.................................................165
3.31 Esteem as starting point and overriding principle...........165
4. Theoretical Principles ...................................................................167
4.1 The standpoint of the observer: Second order
cybernetics ..................................................................................167
4.2. Epistemology and systemic thought......................................169
4.3 Truth, reality and radical constructivism ............................171
4.4 Language and reality construction ........................................173
4.5 Circularity and the principle of cause and effect ...............176
4.6 Complexity, contingency and conflict ...................................180
4.7 Part and whole: Definition of system and context ..............182
5. The family as a special system ...................................................185
5.1 General definition of the family system ................................185
5.2 The Orders of Love ....................................................................187
5.3 Hierarchy and bonding in successive partnerships
and/or families ............................................................................193
6. Clarification of assignment and definition of goal .............195
6.1 Different assignment contexts .................................................195
6.2 Different kinds of assignment in consultation and
psychotherapy .............................................................................197
6.2.1 Assignments from “patients” ....................................................197
6.2.2 Assignments from “identified patients (IP)”.............................197
6.2.3 Assignments from “clients” ......................................................198
6.2.4 Assignments from “visitors”.....................................................200
6.2.5 Assignments from “complainants” ...........................................201
6.2.5.1 Clarifying assignments from complainants........................201
6.2.5.2 Therapeutic procedures and suggestions for complainant
assignments........................................................................203
6.2.5.2.1 Dealing with the “defendant”as a restriction...............203
6.2.5.2.2 Increasing the probability of desired behavior on
the part of the defendant .............................................205
6.2.5.2.3 Behave as though the desired behavior was already
being manifest.............................................................205
6.2.5.2.4 Tracing back behavior sequences or: From the
victim of the problem to the perpetrator of the
solution ......................................................................205
6.2.5.2.5 Restricting complaints ................................................208
6.2.5.2.6 Observing the defendant .............................................208
6.2.6 Assignments from “co-therapists” or “supervisors” .................208
6.3 Clarifying assignments in practice .........................................209
6.3.1 The referral context or: What initiated consultation?................209
6.3.2 Clarification of a direct assignment ..........................................213
6.4 Definition of goals: Constructing goals in consultation ....216
7. The setting in systemic psychotherapy and consultation .........223
7.1 Forms of teamwork ....................................................................223
7.2 Breaks ...........................................................................................226
7.3 The interval between sessions..................................................228
7.4 The duration of sessions............................................................230
7.5 The duration of psychotherapy or consultation..................230
7.6 On the transferability of the systemic setting to
broader psycho-social areas....................................................231
8. The structure of systemic psychotherapy and consultation .........233
8.1 Making an appointment by phone .........................................233
8.2 The first systemic session..........................................................235
8.2.1 Description of the consultation context ....................................236
8.2.2 Clarification of the meaning of consultation.............................237
8.2.3 Clarification of the problem and solution context.....................237
8.2.4 Introduction of the external perspective....................................240
8.2.5 Clarification of the referral context...........................................240
8.2.6 The effects of participating in psychotherapy or refusing it...........242
8.2.6.1 Psychotherapy in mandatory contexts................................242
8.2.6.2 The reactions of relevant persons.......................................245
8.2.7 Previous attempts at solution: Inquire after the client's
Odyssey ....................................................................................246
8.2.8 Clarification of assignment and goal definition ........................247
8.2.9 Break.........................................................................................248
8.2.10 Final commentary and dismissal.............................................248
8.2.11 Collecting data on relevant individuals...................................248
8.3 Subsequent systemic sessions ..................................................248
8.4 Taking stock (cf. SCHMIDT 2004a) .........................................250
8.5 The final session ..........................................................................250
8.6 Catamnesis ...................................................................................251
9. Systemic Interventions ..................................................................253
9.1 Circular and other questions ...................................................253
9.2 „Paradoxical” interventions ....................................................274
9.2.1 The paradox of paradoxical interventions.................................276
9.2.2 Forms of “paradoxical” intervention.........................................277
9.2.2.1 Symptom prescription........................................................277
9.2.2.2 Re-interpretation as a competence-oriented offer of
interpretation......................................................................284
9.2.2.3 „Relabeling” ......................................................................288
9.2.2.4 Utilization of the symptom ................................................289
9.2.2.5 „Relapse” prophylaxis .......................................................293
9.2.2.5.1 Interpreting a „relapse” as a decision..........................295
9.2.2.5.2 Predicting a “relapse” .................................................295
9.2.2.5.3 Inducing a “relapse”....................................................297
9.3 A „conference with the inner firm“ as the basis for a
systemic-constructivist personality theory.......................298
9.4 Family constellations: A ritual to externalize one's
inner picture of one's own family ...........................................308
9.5 Genograms ...................................................................................317
9.6 Prescribing rituals ......................................................................321
9.7 Softening up attributes (according to SCHMIDT 2005)...326
9.8 Pretending ....................................................................................328
9.8.1 Pretending to have a problem/symptom....................................329
9.8.2 Pretending the solution (the miracle) has already been
achieved ...................................................................................331
9.9 One's own future plan provides information for the
present ...........................................................................................333
9.10 Detachment interventions ......................................................334
9.10.1 Esteeming bonds .....................................................................336
9.10.2 Transforming rules..................................................................336
9.10.3 Shaping the course of talks .....................................................338
9.10.4 Prescribing secrets and “disappearances” ...............................339
9.10.5 A well-meaning siege .............................................................343
9.11 Softening up and re-contextualizing rigid
constructions of reality when there are „psychotic“
problems .....................................................................................344
9.12 Observing what is worth preserving ...................................347
9.13 Stimulating competition .........................................................348
9.14 Occurrence and affect .............................................................349
9.15 Introducing a higher power ...................................................349
9.16 “Do something different” .......................................................350
9.17 Three complaints are enough ................................................351
9.18 Metaphors and symbols ..........................................................351
9.19 Splitting ......................................................................................356
9.20 Observation assignments........................................................356
9.21 The psychotherapist's self-management.............................357
9.22 Changing patterns....................................................................359
9.23 Giving needs-focused meaning by dealing with a
psychic symptom in a manner that is not obviously
expected ......................................................................................361
10. Hypnotherapeutic concepts in systemic consultation ......365
10.1 Fundamentals of ERICKSON's hypnotherapy ................365
10.1.1 The unconscious mind ............................................................365
10.1.2 Hypnosis as stimulation of a particular state of
consciousness..........................................................................365
10.2 Hypnotherapeutic premises ...................................................368
10.2.1 Orientation on and activation of competence..........................368
10.2.2 Utilizing the unconscious to develop solution criteria ............368
10.2.3 Symptoms and trance phenomena...........................................369
10.3 Steps towards the construction of tailor-made trance
induction.....................................................................................369
10.4 Hypnosis for dealing with traumatic experiences ............371
10.5 Utilizing dissociative experience ...........................................372
10.6 The hypnotherapeutic effect of language and
communication patterns .........................................................373
10.6.1 “Still”, “yet” and “already” as the great white hope ...............373
10.6.2 Mini breaks in the rhythm of talks ..........................................373
10.7 The power of suggestion .........................................................375
11. Selected Topics..............................................................................379
11.1 Systemic work with abuse ......................................................379
11.2 Violent behavior in youths: A systemic approach............383
11.2.1 Violence as an attempt at solution ..........................................383
11.2.2 The unpredictable effect of forbidding acts of violence .........383
11.2.3 Violence and guilty conscience ..............................................383
11.2.4 Activating and constructing a helpful system of belonging ....384
11.3 Contemplating, threatening and attempting suicide .......385
11.4 Systemic therapy with couples ..............................................388
11.4.1 A couple's love story and procedure in couples therapy .........389
11.4.2 Interrupting patterns by prescribing rituals .............................391
11.4.3 Separation from a partner........................................................394
11.4.4 Abortion and partnership ........................................................395
12. On the problematic nature of psychiatry .............................397
12.1 On the logic of madness: Preliminary models for
explaining mad behavior ........................................................397
12.1.1 The logic of madness ..............................................................399
12.1.1.1 Dissociation of aggressive tendencies..............................400
12.1.1.2 The need for an explanation and the development of a
system of madness (The logic of explanatory
necessities) ......................................................................402
12.1.1.3 Paranoid ideas: The logic of relationships .......................402
12.1.1.4 Literal thinking: Cognitive logic......................................403
12.1.2 Obsession and psychosis: The logic of bonding .....................403
12.1.3 The developmental logic of manic-depressive dynamics .......404
12.2 The organization of ambivalence in psychoses and
borderline cases, and the therapeutic consequences
derived from it .........................................................................406
12.3 The mystification of psychiatry ............................................408
12.4 The distinction between medical and psycho-
therapeutic contexts................................................................409
12. How to produce problems and make them worse or
even chronic...................................................................................413
14. Learning systems in the context of society: Thoughts
on systemic didactics ...................................................................417
14.1 Personal remarks .....................................................................417
14.2 The principle of correlation between content and form..418
14.3 Social context conditions and the dangers of a set
curriculum for systemic psychotherapy .............................422
14.4 Profile of systemic training courses correlating in
form and content ......................................................................428
15. References ......................................................................................431
Figure credits .......................................................................................449
Case and story register ......................................................................451
Index of persons ..................................................................................455
Subject index ........................................................................................461